{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T15:50:16Z","timestamp":1781279416547,"version":"3.54.1"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Severe pneumonia in paediatric patients typically necessitates prolonged courses of antibiotic therapy, a practice that elevates vulnerability to antibiotic\u2010associated diarrhoea (AAD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The present study aimed to evaluate the clinical profiles of paediatric patients with AAD secondary to severe pneumonia and to explore evidence\u2010based nursing interventions for this complication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>A retrospective cohort. This study was conducted at a tertiary hospital in China, enrolling paediatric patients diagnosed with severe pneumonia. To identify independent risk factors for AAD development, a stepwise analytical framework was applied, comprising univariate analysis, correlation analysis and multivariate logistic regression modelling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 306 children with severe pneumonia were included. The overall incidence of secondary AAD among this cohort was 13.73% (42\/306). The median time from antibiotic initiation to AAD onset was 5\u2009days (IQR 3\u20138\u2009days). Multivariate logistic regression analysis identified five independent risk factors for AAD: age &lt;\u20091\u2009year (odds ratio [OR]\u2009=\u20092.246, 95% confidence interval [CI]: 1.821\u20132.909), administration of penicillin\u2010class antibiotics (OR\u2009=\u20092.474, 95% CI: 2.043\u20133.061), antibiotic treatment duration \u2265\u20091\u2009week (OR\u2009=\u20092.970, 95% CI: 2.127\u20133.507), requirement for mechanical ventilation (OR\u2009=\u20093.049, 95% CI: 2.895\u20133.725), and hospital stay &gt;\u200914\u2009days (OR\u2009=\u20091.954, 95% CI: 1.630\u20132.402). In contrast, prophylactic probiotic administration was identified as a protective factor against AAD (OR\u2009=\u20090.801, 95% CI: 0.586\u20130.944).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In clinical practice, stratified management protocols should be implemented for paediatric populations at high risk of AAD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>Core components of such protocols include optimising antibiotic selection and treatment duration, initiating early combined probiotic interventions and enhancing intestinal function monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70424","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T07:09:57Z","timestamp":1773212997000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Risk Factors for Antibiotic\u2010Associated Diarrhoea in Paediatric Patients With Severe Pneumonia: A Retrospective Cohort"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0432-5054","authenticated-orcid":false,"given":"Shuang","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Pediatrics The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University  Huaian Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya","family":"Dan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University  Huaian Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuemei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University  Huaian Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruxin","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University  Huaian Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gengqin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University  Huaian Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"e_1_2_16_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2024-067216"},{"key":"e_1_2_16_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiac082"},{"key":"e_1_2_16_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/20469047.2017.1409455"},{"key":"e_1_2_16_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2025.1575605"},{"key":"e_1_2_16_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0325436"},{"key":"e_1_2_16_7_1","doi-asserted-by":"publisher","DOI":"10.1163\/18762891-bja00086"},{"issue":"10","key":"e_1_2_16_8_1","first-page":"1108","article-title":"A Prospective Randomized Controlled Study on Probiotics for the Prevention of Antibiotic\u2010Associated Diarrhea in Infants and Young Children","volume":"26","author":"Zhang S. W.","year":"2024","journal-title":"Zhongguo Dang Dai Er Ke Za Zhi"},{"key":"e_1_2_16_9_1","doi-asserted-by":"publisher","DOI":"10.4103\/jehp.jehp_1497_23"},{"key":"e_1_2_16_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(24)00078-0"},{"key":"e_1_2_16_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2023.1153070"},{"key":"e_1_2_16_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000003994"},{"issue":"6","key":"e_1_2_16_13_1","first-page":"4","article-title":"Advantages and Disadvantages of Diagnostic Criteria for Severe Pneumonia in Children","volume":"32","author":"Li X.","year":"2017","journal-title":"Chinese Clinical Journal of Practical Pediatrics"},{"issue":"12","key":"e_1_2_16_14_1","first-page":"891","article-title":"Clinical Characteristics and Effect of Nutritional Sequential Treatment in Elderly Patients With Antibiotic\u2010Associated Diarrhea Secondary to Pneumonia","volume":"24","author":"Liu G.","year":"2025","journal-title":"Chinese 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